John Paul Phelan (Carlow-Kilkenny, Fine Gael) | Oireachtas source

I thank Senator Mulherin for raising the matter. The Minister of State, Deputy Daly, was unavailable hence my presence here. It is a serious issue.

The overarching policy of the Government is to support older people to live in dignity and independence in their homes and communities for as long as possible. Home care is an increasingly important part of the supports for enabling older people to remain at home and for facilitating their discharge from acute hospitals. The HSE has operational responsibility for planning, managing and delivering home and other community-based services for older people. Services are provided on the basis of assessed healthcare need. This year the HSE has moved to a single home support service combining home help and home care packages into a single service, the home support services for older people.

Home support services were a particular focus of budget 2018. An additional €18.25 million was allocated. The resources available in 2018 bring the total budget for the direct provision of services to €418 million. The HSE's national service plan provides for a target of €17.094 million home support hours to 50,500 people. A further initiative saw 324 people being provided with home support services following this winter's adverse weather conditions.

The demand for home supports continues to grow in parallel with the increasing number of older people. Many more of our older people with complex care needs are now being maintained at home, leading to increased demand for additional levels of service and for services outside of core hours Monday to Friday.

Arrangements for home care have developed over the years with a significant local focus and there is considerable variation in access to services in different parts of the country. It is also accepted there is considerable demand for home support services over and above existing service levels.

Since 2016, home support in CHO area 2 has been allocated based on prioritised needs of assessed applicants. Since the introduction of the prioritisation system, Mayo has had an increased budget with a corresponding reduction in other parts of the CHO area, particularly in Galway. In March 2018, the last month for which figures are available, Mayo had an over-expenditure of 4.2% on its budget.

The overall budget for CHO area 2 in 2018 is €43.2 million, an increase on both 2016 and 2017. The budget is broken down as follows: Galway, which has 52% of clients has a 56% share of the budget; Mayo has 30% of clients and 29% of the budget; and Roscommon has 18% of clients and 15% of the budget.

As I have said, the demand for home support continues to exceed supply. Those with the highest priority have home support implemented, while those on a lower priority are put on a waiting list. Ongoing measures to maximise the available budget, together with financial support for winter access measures have resulted in additional funding availability. Consequently, a process began in late-April to allocate home support to those on the waiting list.

Those responsible in CHO area 2 are conscious of the significant number of applicants on the home support waiting list. The waiting list includes both those waiting on new services and those awaiting additional hours, with approximately one third awaiting additional hours and two thirds awaiting a new service. When care was offered to those on the waiting list, approximately one third declined the offer. CHO area 2 has, therefore, commenced a process to validate the waiting list. It is envisaged that this process, together with the release of hours from the available budget, will see a noticeable reduction in waiting lists, including in County Mayo, over the coming months.